AIDS

Question 1

HIV char

Answer 1

enveloped, diploid, pos sense, RNA virus

Question 2

HIV VF

Answer 2

Reverse transcriptase, integrase, protease

Question 3

HIV Res

Answer 3

Humans

Question 4

HIV Epid

Answer 4

HIV1 (ww) and HIV2 (africa)

Accumulates mutations rapidly

Question 5

HIV transmission

Answer 5

microabrasions of mucous membranes and enters via blood/bodily fluids

Question 6

HIV RF

Answer 6

unprot sex, parenteral exposure, maternal to infant, transfusions

Question 7

HIV entrance receptors

Answer 7

gp120 binds CD4 and coreceptors = CCR5 (macrophages) or CXCR4 (Th Cells)

Question 8

Initial Entry

Answer 8

HIV to scrapes/abrasions on mucosal surface to picked up by dendritic cells and moved to lymph nodes where it has direct interaction with macrophages (gp120 and CCR5) and T cells (gp120 and CXCR4). Infected cells in lymph nodes within 2 days and plasma within 5 days

Question 9

HIV clinical causes

Answer 9

HIV infects CD4 lymphocytes leading to cell death by cytopath or apop. Abs against gp120 may produce Ag-dependent cytotoxicity (ADCC). CD4s are primarily responsible for delayed type hypersensitivity and cell mediated immunity so as CD4 cells are lost, opportunistic inf and malignancy occurs

Question 10

Timeline overview

Answer 10

Has clinical latency 9wks to 6 yrs as Abs high. Staged by CD4 cell count and presence of signs and symptoms. Staging provides info on clinical mgmt.

Testing is Elisa and western blot to confirm

Question 11

Stage A

Answer 11

Initial infection and seroconversion
Mostly Asymptomatic, if symptomatic it occurs within weeks of infection with mononucleosis like symptoms w/ a rash (affects palms and soles). Highly infectious stage - virus in large concentration in genital fluids. Time for education in diet, exercise, and vaccinations

Question 12

Stage B

Answer 12

Symptomatic and first stage of opportunistic
Swollen lymph nodes (greater than 3 months), malaise with weight loss, recurrent and frequent fevers and sweats. Diarrhea for greater than 1 month, yeast infections, skin rashes, PID in FM, herpes eruptions.
CD4 btwn 400 and 200

Question 13

Infectious conditions assoc with B

Answer 13

Bartonella henselae, oral/genital thrush, Crytosporidium, EBV, Listeriosis, Shingles, TB, Karposi’s Sarcoma

Question 14

Stage C

Answer 14

AIDS. Defined as fewer than 200 CD4 count or clinical presentation of multiple opportunistic infections. Wasting syndrome (Cachexia) with greater than 10% weight loss. Continued chronic diarrhea, weakness and fever. Neuro signs of encepalitis, 26 clinical conditions, Lymphomas

Question 15

LAb

Answer 15

Serology for Abs - Elisa, confirm with western blot

p24 Ag detection - early marker of infection = mRNA first made